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Background <p>Chronic low-grade inflammation plays a central role in the pathophysiology of both type 2 diabetes mellitus (T2DM) and hypertension, contributing to increased cardiovascular risk. Telmisartan, an angiotensin receptor blocker with partial peroxisome proliferator-activated receptor gamma (PPAR-γ) agonist activity, may offer anti-inflammatory benefits in addition to its antihypertensive effects.</p> Aims <p>This study compares the effects of telmisartan versus other standard antihypertensive agents on inflammatory biomarkers, including high-sensitivity C-reactive protein (hsCRP), interleukin-6 (IL-6), and tumour necrosis factor-alpha (TNF-α), in patients with diabetes and newly diagnosed hypertension.</p> Methods <p>This is a randomized, open-label, parallel-group, active-controlled trial. Seventy eligible patients were randomized to receive telmisartan (N = 34) or another antihypertensive agent [amlodipine (n = 22), cilnidipine (n = 12), or ramipril (n = 2)] (N = 36). Secondary outcome parameters included inflammatory biomarkers such as highly sensitive C-reactive protein (hsCRP), interleukin-6 (IL-6), and tumour necrosis factor alpha (TNF-α) measured at baseline and 12&#xa0;weeks following treatment. Data are presented as median and interquartile range (IQR). Between-group comparisons at 12&#xa0;weeks were performed using the Mann–Whitney U test. The trial is registered with the Clinical Trial Registry of India (CTRI/2023/04/051878).</p> Results <p>At baseline, hsCRP, IL-6, and TNF-α levels were comparable between groups. In the telmisartan group, hsCRP declined from 3.4&#xa0;mg/L (IQR: 2.0, 13.7) to 1.8&#xa0;mg/L (IQR: 1.2, 5.0), IL-6 from 4.3&#xa0;pg/mL (IQR: 2.9,9.5) to 3.4&#xa0;pg/ml (IQR: 2.2, 6.8), and TNF-α from 19.4&#xa0;pg/ml (IQR: 8.9, 43.7) to 13.8&#xa0;pg/ml (IQR: 3.5, 32.4). In the active control group, hsCRP changed from 3.1&#xa0;mg/L (IQR: 1.7, 8.0) to 2.9&#xa0;mg/L (IQR: 1.7, 4.9), IL-6 from 4.1&#xa0;pg/ml (IQR: 3.0,7.6) to 4.2&#xa0;pg/ml (IQR: 2.9, 7.8), and TNF-α from 20.2&#xa0;pg/ml (IQR: 10.4, 48.6) to 16.9&#xa0;pg/ml (IQR: 3.3, 30.3). The differences between groups at 12&#xa0;weeks were not statistically significant for hsCRP (P = 0.07), IL-6 (P = 0.24), or TNF-α (P = 0.93).</p> Conclusion <p>The anti-inflammatory markers were reduced in both groups at 12&#xa0;weeks without any statistically significant difference across groups. However, telmisartan was associated with greater reductions in hsCRP, IL-6, and TNF-α in patients with T2DM and hypertension following 12&#xa0;weeks of treatment. These findings may indicate a potential anti-inflammatory effect of telmisartan that requires confirmation in adequately powered trials.</p>

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Anti-inflammatory potential of telmisartan compared to other antihypertensives: secondary outcomes from a randomized trial

  • 期刊论文

  • 发表日期：

    2025年10月5日

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  • Simi Bridjit Gomaz,
  • Jaykaran Charan,
  • Amal Mohandas,
  • Pravesh Aggarwal,
  • Deepak Kumar,
  • Dharmveer Yadav,
  • Ravindra Shukla,
  • Sneha Ambwani,
  • Rimple Jeet Kaur

摘要

Background

Chronic low-grade inflammation plays a central role in the pathophysiology of both type 2 diabetes mellitus (T2DM) and hypertension, contributing to increased cardiovascular risk. Telmisartan, an angiotensin receptor blocker with partial peroxisome proliferator-activated receptor gamma (PPAR-γ) agonist activity, may offer anti-inflammatory benefits in addition to its antihypertensive effects.

Aims

This study compares the effects of telmisartan versus other standard antihypertensive agents on inflammatory biomarkers, including high-sensitivity C-reactive protein (hsCRP), interleukin-6 (IL-6), and tumour necrosis factor-alpha (TNF-α), in patients with diabetes and newly diagnosed hypertension.

Methods

This is a randomized, open-label, parallel-group, active-controlled trial. Seventy eligible patients were randomized to receive telmisartan (N = 34) or another antihypertensive agent [amlodipine (n = 22), cilnidipine (n = 12), or ramipril (n = 2)] (N = 36). Secondary outcome parameters included inflammatory biomarkers such as highly sensitive C-reactive protein (hsCRP), interleukin-6 (IL-6), and tumour necrosis factor alpha (TNF-α) measured at baseline and 12 weeks following treatment. Data are presented as median and interquartile range (IQR). Between-group comparisons at 12 weeks were performed using the Mann–Whitney U test. The trial is registered with the Clinical Trial Registry of India (CTRI/2023/04/051878).

Results

At baseline, hsCRP, IL-6, and TNF-α levels were comparable between groups. In the telmisartan group, hsCRP declined from 3.4 mg/L (IQR: 2.0, 13.7) to 1.8 mg/L (IQR: 1.2, 5.0), IL-6 from 4.3 pg/mL (IQR: 2.9,9.5) to 3.4 pg/ml (IQR: 2.2, 6.8), and TNF-α from 19.4 pg/ml (IQR: 8.9, 43.7) to 13.8 pg/ml (IQR: 3.5, 32.4). In the active control group, hsCRP changed from 3.1 mg/L (IQR: 1.7, 8.0) to 2.9 mg/L (IQR: 1.7, 4.9), IL-6 from 4.1 pg/ml (IQR: 3.0,7.6) to 4.2 pg/ml (IQR: 2.9, 7.8), and TNF-α from 20.2 pg/ml (IQR: 10.4, 48.6) to 16.9 pg/ml (IQR: 3.3, 30.3). The differences between groups at 12 weeks were not statistically significant for hsCRP (P = 0.07), IL-6 (P = 0.24), or TNF-α (P = 0.93).

Conclusion

The anti-inflammatory markers were reduced in both groups at 12 weeks without any statistically significant difference across groups. However, telmisartan was associated with greater reductions in hsCRP, IL-6, and TNF-α in patients with T2DM and hypertension following 12 weeks of treatment. These findings may indicate a potential anti-inflammatory effect of telmisartan that requires confirmation in adequately powered trials.